Advance Search

OPERATING ROOM EFFICIENCY IN A TERTIARY CENTER IN ETHIOPIA

Abraham Genetu Tiruneh
Addis Ababa University
Dr Yonas | Bio
Department of Surgery, Addis Ababa University
Dr Habtamu | Bio
Department of Surgery, Addis Ababa University
Dr Tsegazeab | Bio
Department of Surgery, Addis Ababa University
Prof Abebe | Bio
Department of Surgery, Addis Ababa University
Keywords:
Copyright and Licensing:

Copyright (c) 2022 Ethiopian Medical Journal

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Share:
  • Articles
  • Submited: July 11, 2021
  • Published: March 29, 2022

Abstract

Background: Operating room (OR) efficiency is a measure of how well time and resources are used for their intended purposes in the operating room. Commonly used parameters are cancelation rate, first case start-time, turnover time, and utilization rate. While previous similar study from our hospital showed inefficient OR utilization, the difference in performance among available ORs has not been described.

Methods: A cross sectional study was done at Tikur Anbessa Specialized Hospital, 550 bed tertiary teaching hospital, from November 2, 2020, till Jan 22, 2021. Out of total 9 operating rooms, four, i.e., Gastrointestinal, Gynecology, Pediatric Surgery and Endourology operating rooms were studied for efficiency parameters .

Results: Out of the 570 patients listed for surgery,404 were operated. The average cancellation rate was 27.3%,the highest being for Gynecology OR  (41.5%) and lowest for Pediatric Surgery OR (18.2%). Average start time was 8:43am (SD = ± 25min). Start time was delayed by 43 minutes from the agreed 8:00 am. Only 2.5% of OR days were started within agreed time. Mean turnover time for all ORs was 25.2 minutes, the highest being for Gynecology OR(35min) and lowest for Pediatric Surgery OR(14min). Average OR utilization was 6hrs 30 min, which was 72%  of the daily allocated 8hrs time.

Conclusion: Our operating rooms have a high cancellation rate and delayed start time. Turn over time and OR utilization were in general acceptable. There were significant differences in efficiency parameters across the four ORs. The OR manager in collaboration with all teams should work on improving start time and cancellation rates, and also identify why some ORs performed better than others while in the same institution.

PDF
PDF

Downloads

Download data is not yet available.

References

  1. Shrime MG, Dare AJ, Alkire BC, O’Neill K, Meara JG. Catastrophic expenditure to pay for surgery worldwide: a modelling study. Lancet Global Health. 2015 Apr 27;3:S38–44.
  2. Negash S, Anberber E, Ayele B, Ashebir Z, Abate A, Bitew S, et al. Operating room efficiency in a low resource setting: a pilot study from a large tertiary referral center in Ethiopia. Patient Saf Surg. 2022 Dec;16 (1):3.
  3. van As AB, Brey Z, Numanoglu A. Improving operating theatre efficiency in South Africa. Sou Af Med J. 101 (7):444–8.
  4. SaLTS Strategic Plan. Federal Ministry of Health, Ethiopia. 2016.
  5. Macario A. Are Your Hospital Operating Rooms “Efficient”?: A Scoring System with Eight Performance Indicators. Anesthesiology. 2006 Aug 1;105(2):237–40.
  6. Desta M, Manaye A, Tefera A, Worku A, Wale A, Mebrat A, et al. Incidence and causes of cancellations of elective operating on the intended day of surgery at a tertiary referral academic medical center in Ethiopia. Patient Saf Surg. 2018 Aug 27;12(1):25.
  7. Tait AR, Voepel-Lewis T, Munro HM, Gutstein HB, Reynolds PI. Cancellation of pediatric outpatient surgery: economic and emotional implications for patients and their families. J Clin Anesth. 1997 May;9(3):213–9.
  8. Prevalence and Predictors of Cancellation of Elective Surgical Procedures at a Tertiary Hospital in Uganda: A Cross-Sectional Study.
  9. Lecturer and Senior Anesthetist, Department of Anesthesia, Jimma University, Ethiopia., M H, Desalegn N, College of Public Health and Medical Sciences, Department of Anesthesia, Jimma University, Ethiopia. Prospective Study of Proportions and Causes of Cancellation of Surgical operations at Jimma University Teaching Hospital, Ethiopia. Int J Anesthesiol Res. 2015 Mar 11;87–90.
  10. Ayele AS, Weldeyohannes M, Tekalegn Y. Magnitude and Reasons of Surgical Case Cancellation at a Specialized Hospital in Ethiopia. 2019;10(12):5.
  11. McGowan JE, Truwit JD, Cipriano P, Howell RE, VanBree M, Garson A, et al. Operating Room Efficiency and Hospital Capacity: Factors Affecting Operating Room Use During Maximum Hospital Census. J Am Coll Surg. 2007 May;204(5):865–71.
  12. Dexter F, Blake JT, Penning DH, Lubarsky DA. Calculating a potential increase in hospital margin for elective surgery by changing operating room time allocations or increasing nursing staff to permit completion of
  13. more cases: a case study. Anesth Analg. 2002 Jan;94(1):138–42, table of contents.
  14. Cansdell D, King M, Smith DG. Operating Theatre Efficiency Guidelines. :82.
  15. Operating Theatre Efficiency Guidelines: A guide to the efficient management of operating theatres in New South Wales hospitals. 2014. 1–80 p.
  16. Milewski F. Operating Room Utilization and Perioperative Process Flow. :15.
  17. Mizumoto R, Cristaudo AT, Hendahewa R. A surgeon-led model to improve operating theatre change-over time and overall efficiency: A randomised controlled trial. Int J Surg Lond Engl. 2016 Jun;30:83–9.
How to Cite
Tiruneh, A. G., Ademe, Y. ., Zeru, H. A., Leake, T. ., & Bekele, P. A. (2022). OPERATING ROOM EFFICIENCY IN A TERTIARY CENTER IN ETHIOPIA. Ethiopian Medical Journal, 60(2). Retrieved from https://www.emjema.org/index.php/EMJ/article/view/1945

Send mail to Author

Send Cancel